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Dig Dis Sci. 2018 Feb;63(2):429-436. doi: 10.1007/s10620-017-4893-3. Epub 2018 Jan 4.

Exploring Gut Microbiota Composition as an Indicator of Clinical Response to Dietary FODMAP Restriction in Patients with Irritable Bowel Syndrome.

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Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Lovisenberggata 21, 0440, Oslo, Norway.
Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
Department of Clinical Nutrition, Lovisenberg Diaconal Hospital, Oslo, Norway.
Department of Clinical Medicine, Center for Nutrition, University of Bergen, Bergen, Norway.
Department of Medicine, Section of Gastroenterology, Haukeland University Hospital, Bergen, Norway.
Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway.



A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) may relieve symptoms of irritable bowel syndrome (IBS). However, nutritional counseling is resource-demanding and not all patients will benefit.


To explore whether gut microbial composition may identify symptom response to a low-FODMAP diet in patients with IBS.


Patients were recruited consecutively to participate in a 4-week FODMAP-restricted diet. Response to diet was defined as ≥ 50% decrease in IBS symptom severity scores (IBS-SSS) compared to baseline. Fecal microbiota were analyzed by a commercially available method (the GA-map™ Dysbiosis Test), assessing 54 bacterial markers targeting more than 300 bacteria at different taxonomic levels.


Sixty-one patients (54 F; 7 M) were included: 32 (29 F; 3 M) classified as responders and 29 (25 F; 4 M) as non-responders. Ten of the 54 bacterial markers differed significantly between responders and non-responders. Based on median values (used as cutoff) of responders for these 10 bacterial markers, we constructed a Response Index (RI): Each patient was given a point when the value for each selected bacterial marker differed from the cutoff. These points were summed up, giving an RI from 0 to 10. Patients with RI > 3 were 5 times more likely to respond (OR = 5.05, 95% CI [1.58; 16.10]), and the probability to respond was 83.4%, 95% CI [61.2-94%].


Gut microbial composition, assessed by using a new RI, may constitute a tool to identify patients that are likely to respond to dietary FODMAP restriction.


Clinical nutrition; Functional gastrointestinal disorders; Gut microbiome; Irritable bowel severity scoring system

[Indexed for MEDLINE]

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